Article

Impact of war, religiosity and ideology on PTSD and psychiatric disorders in adolescents from Gaza Strip and South Lebanon

March 2012
Social Science & Medicine 74(12):2005-11

March 2012
74(12):2005-11

DOI:10.1016/j.socscimed.2012.02.025

Source
PubMed

Authors:

Vivian Khamis

American University of Beirut

This study investigated the extent to which differences in the types of war trauma, economic pressure, religiosity and ideology accounted for variation in PTSD and psychiatric disorders among adolescents from Gaza Strip and South Lebanon. Participants were 600 adolescents aged 12-16 years. They were selected from the public school system in the highly war exposed areas. Questionnaires were administered in an interview format with adolescents at school by two trained psychologists. Results indicated that the various types of trauma had differential effects on the psychological status of adolescents in both countries. Economic pressure was more predictive of PTSD and psychological distress in adolescents from Gaza. Differences in religiosity and ideology did not account for similar variation in stress response among adolescents from Gaza and South Lebanon. While higher levels of religiosity evidenced the greatest levels of depression and anxiety in adolescents from Gaza, religiosity had an attenuated effect on adolescents from South Lebanon. Ideology was negatively associated with depression and anxiety in Gaza strip adolescents, whereas it did not play a role for adolescents from South Lebanon. The clinical and research implications of these conclusions are discussed.

Consequences of war-related traumatic stress among Palestinian young people in the Gaza Strip: A scoping review

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Dec 2023

Neuroticism as Mediator and Moderator Between War Atrocities and Psychopathology in Syrian Refugee Children and Adolescents

Article

Full-text available

Jan 2022

Vivian Khamis

Background Despite the extensive research on war atrocities and risk factors for psychopathology, there is a paucity of research on the potential mediating and moderating effect of neuroticism in refugee children and adolescents. Objective This study aimed to analyze whether neuroticism mediated and/or moderated the relationship between war atrocities and different types of psychopathology in Syrian refugee children and adolescents who resettled in Lebanon and Jordan. Participants and Setting Participants were 1,000 Syrian refugee children and adolescents of both sexes. Methods Questionnaires were administered in an interview format with children at school by two trained psychologists. Descriptive statistics and inter-correlations among variables were used Then the mediator and moderator effect of neuroticism in the relationship between war atrocities and posttraumatic stress, emotion regulation and behavioral and emotional disorders were examined. Results A partial mediating effect of neuroticism on posttraumatic stress disorder (PTSD), emotion dysregulation, and emotional and behavioral disorders was revealed. Findings also indicated full moderating effects of neuroticism on PTSD as well as partial moderating effects on emotion dysregulation, and emotional and behavioral. Conclusions Findings contribute to the neuroticism literature by showing that high-N children develop more problems that are psychopathological and have more severe affective reactions to war atrocities in post- resettlement contexts. Early interventions aimed to reduce neuroticism might contribute to a better prognosis in refugee children at high-risk for psychological disorders.

Traumatic Events and PTSD Among Palestinian Children and Adolescents: The Effect of Demographic and Socioeconomic Factors

Article

Full-text available

Mar 2020

Background The situation in the Gaza Strip is uncommon in the frequency with which children are exposed to war-related traumatic events on a daily basis and because of the long-term nature of the conflict. The prevalence of posttraumatic stress disorder (PTSD) among children and adolescents in the Gaza Strip increased after the recent wars. The aims of the study are: To investigate the prevalence and nature of war traumatic events and PTSD; and to investigate how these traumatic events predict PTSD when taking into account demographic and socioeconomic status factors amongst Palestinian children and adolescents in the Gaza Strip. Methods The sample consists of 1,029 school pupils (11–17 years old): 533 (51.8%) were female and 496 (48.2%) were male. War-Traumatic Events Checklist (W-TECh) Post-Traumatic Stress Disorders Symptoms Scale (PTSDSS) were used. Results The majority of children and adolescents experienced personal trauma (N: 909; 88.4%), witnessed trauma to others (N: 861; 83.7%) and observed demolition of property (N: 908; 88.3%) during the war. Compared to girls, boys showed significantly more exposure to all three event types as well as overall traumatic events. Results also demonstrated that the prevalence of DSM-V PTSD diagnosis was 53.5% (N = 549). Further, children who had experienced personal trauma, trauma to others, and the demolition of property were significantly more likely to be diagnosed with PTSD compared to those who had not, even when adjusting for demographic and socioeconomic factors. The strongest war trauma for PTSD is personal trauma followed by witnessing trauma and then observing demolition of properties. Conclusions The study provides valuable evidence that demographic and socioeconomic factors mediate the relationship between different war traumatic events and PTSD. Interventions should take into account the children’s background including their gender, age, where they live, and their socioeconomic status (e.g., family income, parents' educational level, family size) to alleviate the psychological symptoms and to enhance their resilience.

The Trauma of Chechen Refugee Women Living in Turkey: Meaning-Making and Coping Strategies

Article

Jun 2018

Hatice Ekici

War atrocities and inattention-hyperactivity: The mediating role of religiosity in children

Article

Sep 2018

Vivian Khamis

The study investigated whether religiosity mediates or moderates the relationship between war atrocities and inattention-hyperactivity in children from Gaza Strip and South Lebanon. Participants were 600 children aged 12–16 years, of whom 273 were males and 327 were females from public schools. Questionnaires were administered by two psychologists. To examine the mediating and moderating effects of religiosity, Baron and Kenney’s mediational criteria and hierarchal regression analysis were conducted. Results indicated that religiosity mediated and moderated the relationship between war atrocities and inattention–hyperactivity in children. The clinical and research implications of these conclusions are discussed.

Mitigation of Posttraumatic Stress Symptoms From Chronic Terror Attacks on Southern Israel

Article

Full-text available

Feb 2017

Since 2000, the southern Israeli town of Sderot and neighboring rural region, Otef Aza, have been frequently exposed to nearly identical terror attacks by Hamas. While only a small minority of Otef Aza residents have been diagnosed with posttraumatic stress disorder (PTSD), more than a third of Sderot residents have been so diagnosed. Factors such as social cohesion and ideology may be the unique factors that protect Otef Aza residents from PTSD; however, a gap in the literature exists as to how these same factors might affect PTSD symptomology in Sderot residents. Orthodox religiosity has also been associated with reduced PTSD symptoms in Sderot; however, previous research on religiosity analyzed demographic characteristics and did not use a measure specifically assessing dimensions of religiosity. The purpose of this quantitative study was to examine the impact of community, ideology, and religiosity on PTSD symptoms among Sderot residents. A survey was distributed to a convenience sample of Sderot residents that 118 participants successfully completed. Standard multiple linear regression revealed that ideology, intrinsic religiosity, nonorganizational religious activity, and fulfillment of needs dimension of sense of community were significant predictors of PTSD symptomatology. Study findings suggested protective factors which could help a large portion of the population. The implications for positive social change for Sderot residents include increased positive interactions, sense of well-being, meaning, and value in their lives.

Coping strategies and personal growth: The case of Palestinian refugees in Shatila camp, Lebanon

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Mar 2023

This study investigated the relationship between coping strategies used by adolescent refugees in the Palestinian refugees’ Shatila camp in Lebanon and posttraumatic growth. Moreover, the study explored and predicted the impact of coping strategies utilized by adolescent Palestinians in Shatila camp, Lebanon on their personal growth and psychological well-being. Data were collected using two questionnaires and a checklist: (a) LEC-5 checklist as an assessment tool to make sure that all the participants have faced or experienced stressful events, (b) questionnaires including the Ways of Coping Questionnaire (WCQ) to find out the style of coping refugees used, and (c) Posttraumatic Growth Inventory (PTGI) to identify the factors of growth refugees developed as a result of using different coping strategies. Sixty adolescent refugees at one of the centers in the camp (31 females and 29 males) who benefited from counseling services participated in the study. Adolescent refugees’ performance on the checklist and questionnaires revealed the prevalence of stressors among the refugees. The coping strategies mostly utilized were problem-focused coping strategies, as there was a correlation between its factors and some coping strategies, and there were coping strategies used that predict the development of growth among. Finally, as for the counseling and training programs and services, interventions and guidance services seem to better prepare refugees to handle and cope with the stress that they encounter to develop personal growth.

Internalized Sexual Orientation Stigma and Mental Health in a Religiously Diverse Sample of Gay and Bisexual Men in Lebanon

Article

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Jan 2022

This study explores the correlates of internalized sexual orientation stigma, psychological distress and depression in a religiously diverse sample of gay and bisexual men in Lebanon. A convenience sample of 200 participants completed a cross-sectional survey. Bisexual men reported greater internalized sexual orientation stigma and less outness to their family and were more likely to face family pressure to have a heterosexual marriage than gay men. People of no religion reported more outness than Muslims and Christians but also higher psychological distress and depression. Multiple regression analyses showed that religiosity, outness, family pressure to marry and being bisexual were positively associated with internalized sexual orientation stigma; and that frequency of attending one's place of worship was negatively associated with psychological distress and depression. Individuals may be coping with adversity through engagement with institutionalized religion, which also appears to be a source of negative social representations concerning their sexuality.

The Relationship Between Spirituality and Post-Traumatic Stress Symptoms in Syrian Adolescents in Jordan

Article

Full-text available

Sep 2022
J Child Adolesc Trauma

The civil war in Syria began in 2011 and escalated over years resulting in one of the largest humanitarian crises since the Second World War. Injury, loss, poverty, and immigration trapped the Syrian population in a diversity of psychological disorders, including post-traumatic stress disorder (PTSD). Spirituality has, on the other hand, been consistently reported as a resilient factor against developing mental disorders. Hence, spirituality or religiosity have been incorporated in clinical and psychotherapeutic practice for several mental disorders. We explored the association between spirituality and the development of PTSD symptoms among Syrian refugee adolescents in Jordanian schools. A sample of 418 Syrian adolescent students (age range between 12–16 years) from Jordanian schools in the northern part of the country were enrolled in the study after informing on study context and objectives. The study questionnaire included sample demographics, smoking status, PTSD checklist – Civilian Version (PCL-C), two spirituality-targeting questions, and trauma and loss history. `Almost half of participants (N = 196) showed moderate PTSD symptoms while around 30% (N = 124) had a severe level of PTSD symptoms. On the other hand, 3 out of four students perceived themselves as highly spiritual. The study resulted in a positive correlation between belief in God and God’s thankfulness. Furthermore, increased spirituality level did not appear to lower the risk of developing PTSD symptoms. Spiritual self-perception of Syrian refugee adolescents showed neither protective nor aggravating effect of on the occurrence of post-traumatic stress symptoms. Additional research and more accurate tools are needed to assess the potential impact of spiritual/religious values towards PTSD symptoms among adolescents.

Potential impact of the COVID-19 pandemic on mental health outcomes in societies with economic and political instability: case of Lebanon

Article

Full-text available

Aug 2020

Purpose Coronavirus disease 2019 (COVID-19) is an infectious disease that has rapidly spread to most cities in the world since December 2019 causing a rise in global mortality and adverse effects on mental health. This paper aims to examine the potential implications of the pandemic for mental health in societies with economic and political instability, focusing on Lebanon. Design/methodology/approach Previous empirical research into mental health and COVID-19 was examined in relation to the Lebanese context. Findings There is a risk of poor mental health in Lebanon owing to the deleterious effects of military conflict and political instability over several decades. More recently, the country is also experiencing the worst economic crisis in its history with unprecedented rates of unemployment, inflation, poverty, and devaluation of the national currency. It is suggested that the lockdown measures may be depriving the Lebanese people of effective coping strategies, such as group memberships (e.g., religion), social support and community involvement, during the COVID-19 outbreak. This in turn may lead to the deployment of maladaptive coping strategies in the population. Practical implications Mental health services are still in their formative phases in Lebanon and mostly run by civil society organizations. There is an urgent need for a national action plan to respond to the potential mental health burden and use of maladaptive coping strategies which may arise in the aftermath of COVID-19. Originality/value This paper provides a novel analysis of mental health in Lebanese society through the lens of social, political, economic and psychological factors.

How to help war-affected children-effectiveness of psychosocial intervention

Thesis

Nov 2018

Marwan Diab

ABSTRACT Background. Research is ample about the destructive effects of armed conflict and violence on the mental health of children. After war trauma, children may face difficulty controlling their feelings, may withdraw from social contacts, and experience concentration problems at school and feel lonely and isolated. Therefore, war-affected children need all possible help to assist them in overcoming their difficulties. Purpose. Interventions with children in settings of armed conflict aim at reducing psychopathology and aiding healthy development, protective factors, and resilience to overcome traumatic war experiences. As a result, this study investigated the effectiveness of psychosocial interventions in enhancing social relations and the resilience of war-affected children, and the protective role of emotion regulation in supporting their mental health. Method. After the Gaza War (2008–2009), children were randomly selected from schools in Gaza-Palestine to join the psychosocial intervention which was designed to prevent the consequences of trauma. The sample for (article I) and (article II) consisted of 482 children of 10–13-years, who were allocated to the intervention group or to the control/waiting list group. The assessments were measured at baseline (T1), at postintervention two months later (T2), and follow-up six months postintervention (T3). The sample for (Article III) was 482 Palestinian children, who represent the baseline group of (Article I & Article II). In article I, we examined the effectiveness of the Teaching Recovery Technique, TRT, psychosocial intervention in enhancing good social relations and investigated whether these enhanced social relations would mediate the intervention effect on mental health in Palestinian children. The children reported the quality of peer (friendship and loneliness) and sibling (intimacy, warmth, conflict, and rivalry) relations, and posttraumatic stress, depressive and psychological distress symptoms, as well as psychosocial well-being. In Article II, we investigated the effectiveness of psychosocial intervention in strengthening resilience among war-affected children and the moderating role of family in affecting a child’s resilience. Children reported positive indicators of their mental health (prosocial behaviour and psychosocial well-being). Mothers reported about their willingness to serve as an attachment figure, and the child reported about the family atmosphere. In Article III, we first tested the protective (moderator) function of different Emotion Regulation (ER) strategies among Palestinian children as well as the direct associations between ER and multiple mental health outcomes. Second, we tested whether the protective function of ER differed between boys and girls or if there were gender differences in the direct associations between ER strategies and mental health. ER was assessed by the Emotion Regulation Questionnaire and mental health by post-traumatic stress (Children’s Impact Event Scale), depressive, and psychological distress (Strengths and Difficulties Questionnaire) symptoms, and by psychosocial well-being (Mental Health Continuum-Short Form). War trauma involved 42 events. Results. The results for Article I showed gender-specific TRT intervention effects: Loneliness in peer relations reduced among boys and sibling rivalry reduced among girls. The TRT prevented the increase in sibling conflict that happened in the control group. The mediating hypothesis was partially substantiated for improved peer relations, and beneficial changes in sibling relations were generally associated with improved mental health. The results for Article II showed that the intervention was not associated with a statistically significant rise in the level of wellbeing or prosocial behaviour among children. In addition, the intervention outcome was not moderated by the mother’s acceptance and willingness to serve as an attachment figure, nor by family atmosphere. The results for Article III showed, first, that none of the ER strategies could protect a child’s mental health from negative impact of war trauma, but self-focused ER was associated with low depressive symptoms, and other-facilitated ER with high psychological well-being. However, controlling of emotions formed a comprehensive risk for children’s mental health. Second, gender differences were found in the protective role of ER, as self-focused and distractive ER formed a vulnerability among boys. Conclusion. The study results and discussion of literature on psychosocial intervention for war-affected areas demonstrate the vital role of social resources, resilience factors, and emotion regulation in promoting the mental health and development of war-affected children.

Palestinian Refugee Children: A Review of the Literature

Article

Full-text available

Jan 2018

Elizabeth Wehbe

Foster parents exposed to political violence: The role of support in addressing emotional and functional difficulties

Article

Dec 2017
CHILD YOUTH SERV REV

Background Being a foster parent is stressful. It becomes even more stressful when foster parents face major threats to their own families and to the foster children in their care, such as during war situations. This study focuses on foster parents' reactions to the war with Gaza in southern Israel that took place in 2014. The first goal of this study was to describe posttraumatic symptoms (PTS) and problems in functioning among foster parents following their exposure to the war. The second goal was to identify background and social support predictors of PTS and functioning problems among these parents. The third goal was to examine the role of formal and informal support received by the parents as a moderator of the association between exposure to war events and PTS and problems in functioning. Methods Participants were 354 Israeli foster parents who were exposed to the war. Participants completed structured instruments of exposure to war events, PTS, functioning, and social support. Results Exposure to war events was associated with PTS and related functioning problems. Education and religiosity were correlated with PTS and problems in functioning. Contrary to our hypothesis, more formal social support was associated with more PTS. Social support did not moderate the association between exposure to war events and PTS. Discussion The unexpected positive correlation between support and PTS was interpreted as either reflecting the fact that foster care agencies targeted foster parents who were most in need, or as a reflection of the inadequacy of the support they received. The findings indicate that foster parents need support during times of major stressful events such as natural disasters and wars, so that they will be able to help the children in their care. Specialized professional training for foster care workers needs to be implemented. Future longitudinal and mix-methods studies are suggested to help address the limitations of the present study.

Community trauma exposure and post-traumatic stress disorder in Chinese children and adolescents

Article

Full-text available

Oct 2023

Background An increasing number of studies have shown the association between traumatic events occurring in childhood and adolescence and post-traumatic stress disorder (PTSD). A gap remains in the literature on the epidemiology and influencing factors of traumatic events and post-traumatic stress disorder in communities in northern China. This study aimed to determine the prevalence of traumatic events and PTSD in communities in northern China, to explore the types of stressful traumatic events and the impact of these traumatic events on children and adolescents, and to investigate the effect of sociodemographic factors on PTSD. Methods A cross-sectional survey study was conducted among 6,027 students (7–17 years old) from 6 cities in Liaoning Province, China. The sample consisted of 2,853 males (47.34%) and 3,174 females (52.66%). The Essen Trauma-Inventory for Children and Adolescents (ETI-CA) Scale was used. The ETI-CA has 5 sections, which include type of traumatic events, worst traumatic event, post-traumatic symptoms, onset, duration, burden of PTSD, and present difficulties in different areas of life. PTSD symptoms were assessed with 23 items in Part 3 of the ETI-CA. Results We found that 2,068 (34.3%) of 6,027 participants experienced trauma events and 686 (33.2%) of 2,068 reported PTSD. Among trauma-exposed youth (2,068), the sudden death of close relatives (33.9%), serious accidents (20.9%), and parental divorce (15.5%) were reported as the worst traumatic events. Studies have shown that after exposure to stressful life events, more than 30% of people feel nervous or upset (39.8%), scared (33.4%), helpless (32.6%), and about 10% have headaches (15.5%), rapid heartbeat (13.3%), and dizziness (11.8%). Multivariable logistic regression analyses showed that students in middle school [OR = 1.29 (1.016, 1.637)], not a student leader [OR = 0.738 (0.618, 0.881)], and their parents in single marital status significantly predicted higher PTSD prevalence the remarried [OR = 0.474 (0.252, 0.893)], married [OR = 0.42 (0.227, 0.778)]. Conclusion The present study suggests the government to train psychological counselors in schools and communities to provide emotional and psychological support, as well as the school leaders and parents to elevate adolescents' psychological suzhi. Particularly, counseling and professional support should be given to those students whose parents are single.

Prevalence of Post-Traumatic Stress Disorder and Associated Factors in Post- Conflict Areas, North Shoa Zone, Ethiopia: A Community Based Cross- Sectional Study

Preprint

Full-text available

Sep 2023

Background Post-traumatic stress disorder places an enormous burden on conflict-affected society. People in conflict-affected areas have higher rates of mental disorders, in particular post-traumatic stress disorder, than those usually found in the non-conflict-affected general population. There is scarce evidence in Ethiopia regarding post-traumatic stress disorder in residents of conflict-affected areas. Therefore, the aim of this study is to assess the prevalence and associated factors of Post-Traumatic Stress Disorder among people in a post-conflict area, North Shoa, Ethiopia. Methods A community-based cross-sectional study design was employed from May 24-June 24, 2022, in the North Shoa Zone, Amhara, Ethiopia. The Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) was used to measure the symptoms of Post-Traumatic Stress Disorder, and the data was collected by direct interview. All collected data were entered into Epi Data version 4.6 and analyzed with SPSS version 25. Bivariable and multivariable regression models were used to determine the factors associated with Post-traumatic stress disorder symptoms. A p-value of less than 0.05 was considered statistically significant. Result A total of 830 participants were interviewed with a response rate of 96%. The estimated prevalence of Post-Traumatic Stress Disorder was found to be 63% (95% CI 60–66%). In the multivariable logistic regression, being female (AOR = 4.2, 95% CI (2.82, 6.27)), being unable to read and write (AOR = 3.08, 95% CI (1.67, 5.69)), witnessing the murder of loved ones (AOR = 3.28, 95% CI (1.58, 6.79)), witnessing the murder of strangers (AOR = 2.04, 95% CI (1.33, 3.11)), being verbally threatened or insulted (AOR = 4.09, 95% CI (2.69, 6.21)). Having poor and moderate social support (AOR = 5.26, 95% CI (3.35, 8.28)), (AOR = 1.89, 95% CI (1.15, 3.13)), respectively, was significantly associated with Post-Traumatic Stress Disorder. Conclusion More than half of the dwellers living in conflict-affected areas experienced post-traumatic stress disorder. Treating and using coping mechanisms regarding identified factors is a way to minimize the burden of post-traumatic stress disorder.

Difficulties in Emotion Regulation Among Syrian Refugee Girls: Risk and Protective Factors

Article

Full-text available

Jan 2023

Vivian Khamis

Exposure to war and forced migration have been widely linked to child subsequent adaptation. What remains sparse is research spanning multiple risk and protective factors and examining their unique, and relative implications to difficulties on emotion dysregulation in refugee girls. This study investigated the mechanisms through which emotion dysregulation in Syrian refugee girls is impacted by exposure to war traumas, comorbidities, and other risk and protective factors such as coping styles, family relationships, and school environment. The sample consisted of 539 Syrian refugee girls who ranged in age from 7 to 18 years attending public schools in various governorates in Lebanon and Jordan. Two school counselors carried out the interviews with children at school. Results indicated that war trauma and the combination of comorbidities associated with negative coping styles could lead to an overall state of emotion dysregulation in refugee girls. Enhanced understanding of the mechanistic role of risk and protective factors in contributing to emotion dysregulation in refugee girls may contribute to the development of effective interventions to target the psychological effects of the refugee experience. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Political Economy of Health in the Gaza Strip (Occupied Palestinian Territory) Contact information

Technical Report

Full-text available

Nov 2021

Mona A.S. Jebril

Post-Traumatic Stress Disorder among Victims of Great March of Return in the Gaza Strip, Palestine: a Need for Policy Intervention

Article

Nov 2021
ARCH PSYCHIAT NURS

This study aimed to assess the level of Post-Traumatic Stress Disorder ( PSTD) and to examine the relationship between exposure to war stress and posttraumatic symptoms among people who were injured during the Great March of Return (GMR) in the Gaza Strip, Palestine. A sample of 264 adults who were injured during participation in the events of GMR completed the Impact Event Scale-Revised (IES-R). IES-R has three sub-scales; intrusion, avoidance, and hyper-arousal. Only 27.3% of the participants had two or more injuries and 38.4% of participants reported having disability due to their injuries. The results showed that 95.4% of the participants had severe posttraumatic symptoms. Total score of IES-R ranged between 29 and 88 (mean = 61.28). The most frequent symptoms of trauma subscales was “Intrusion” (mean=2.90), followed by “Avoidance” (mean=2.73), and then “Hyper-arousal” (mean=2.70). Level of PTSD was affected by working status, need for hospitalization, need for a referral for treatment outside the Gaza Strip, disability and severity of injury. Such high level of PSTD will have negative consequences on participants’ physical and mental status. Therefore, a need for special counselling programs is required to help them to survive with least consequences of PTSD on their wellbeing.

Human (in)security and psychological well‐being in Palestinian children living amidst military violence: A qualitative participatory research using interactive maps

Article

Full-text available

Oct 2021

Introduction: Research has widely evidenced the effects of war and political violence on the functioning of children, with a great accord in diagnosing children's psychological burdens related to their exposure to violence. Yet, within this literature, the influence of the chronic sense of insecurity on their psychological functioning during and after hostilities remains unexplored. Methods: The present study aimed at exploring interrelated relationships between the perceived insecurity and the children's psychological well-being and their adjustment to trauma. Based on drawings and walk-along interviews with 75 Palestinian children, residents of both the West Bank and Gaza Strip, we offer an analysis of human security-related risks and protective factors that contribute to either promoting or undermining the child's psychological functioning in a context characterized by chronic instability and political violence. Results: A complex network of sources of security and insecurity emerged from the narratives depicting an ecological portrait encompassing the determinants of children's mental health and psychological functioning. The TCA led to the identification of 8 main themes: school and associativism; social relations and house as a source of security/insecurity; military occupation as a source of insecurity; national and political identity as a source of safety; mosque and spirituality as a source of safety/unsafety; environment as a source of security/insecurity; mental health. Discussion: An approach encompassing human security as an explicative model can help in exhaustively portraying the complexity of the Palestinian children's suffering and their competence in adjusting to their traumatic reality. The study draws attention to social, political, environmental, and economic determinants of children psychological well-being.

Making meaning of community violence among adolescents: Associations between exposure, pro‐violence attitudes and psychological symptoms

Article

Oct 2021

This study examined one type of adolescent meaning making (i.e., the development of beliefs about violence) and its association with reported mental health symptoms in a sample of youth exposed to community violence. Eighty-seven adolescents (age 11–18; 64.4% female) from a metropolitan city in the Northeast were recruited through Craigslist and recreation center postings and data collection occurred from 2009 to 2013. Participants completed self-reported measures of community violence exposure, attitudes toward violence, and psychological symptoms of depression and posttraumatic stress disorder [PTSD]. Bivariate correlations, hierarchical linear regressions, and mediation analyses examined the associations between exposure, beliefs about violence, and mental health symptoms. Self-reported pro-violence attitudes were positively correlated with depression symptoms (r = 0.32, p < 0.01) and PTSD (r = 0.45, p < 0.01). Pro-violence attitudes significantly mediated the relationship between community violence exposure and depression symptoms (95% confidence interval [CI] = 0.003–0.061) and PTSD symptoms (95% CI = 0.046–0.260). Preliminary findings suggest that meaning making through the development of pro-violence attitudes may not protect against symptoms of PTSD and depression among youth. Findings can inform the integration of meaning making processes into community mental health interventions for youth.

Spirituality, religiousness, and mental health: A review of the current scientific evidence

Article

Full-text available

Sep 2021

Research in the field of "Spirituality and Health" has been growing, with spirituality/religiousness (S/R) being consistently related to both physical and mental health. The objective of this article is to provide an updated review of the current scientific evidence on the relationship between S/R and mental health, highlighting the most important studies. As a secondary objective, the mechanisms that explain this relationship and the interventions that utilize this information in treating mental disorders will be discussed. The findings reveal a large body of evidence across numerous psychiatric disorders. Although solid evidence is now available for depression, suicidality, and substance use, other diagnosis, such as post-traumatic stress disorder, psychosis, and anxiety, have also shown promising results. The effects of S/R on mental health are likely bidirectional, and the manner in which religious beliefs are used to cope with distress (i.e. negative and positive), may affect mental health outcomes. Despite these findings, the mechanisms that explain these associations and the role of S/R interventions need further study. Concerning clinical practice, mental health providers should ask patients about S/R that are important in their lives to provide holistic and patient-centered care.

Mindfulness, Self-compassion and Resilience among Fifth Graders at Al Makassed Dawha School in Lebanon

Article

Full-text available

Jan 2021

Elementary school students in Lebanon are subjected to various adversities and difficulties. Promoting mindfulness and self-compassion is important in affecting their resilience so that they can overcome these adversities. This study aims at assessing the mindfulness, self-compassion, and resilience among fifth graders at Al Makassed Dawha School in Lebanon. To achieve this aim, fifty students were involved in this study. The extent to which students were originally mindful, self-compassionate, and resilient was measured using different surveys. The collected data were analyzed using SPSS version 25.0, and the relation between these variables was statistically tested using Chi-square and Kendall tests. The impact of self-compassion and mindfulness on resilience was deduced from students’ reflection on the implementation of the Mindful Self-Compassion Program (MSC). The results showed that the majority of the enrolled fifth graders in this study had good standing self-compassion and resilience, but they had low levels of mindfulness. Mindfulness and self-compassion are found to be positively and significantly correlated with each other. The MSC was partially implemented and the highest good standing percent (90%) was recorded in the self-compassion test, while the lowest students being in the good standing category was in the mindfulness test results (46%). As for the number in the good standing category, it mounted up to 70%. The research recommends the need for following up the development programs of mindfulness, self-compassion, and resilience within the school context and promoting awareness about their importance. Keywords— Fifth-graders, Mindfulness, Resilience, Self-Compassion

Prevalence and associated factors of post-traumatic stress disorder in Lebanon: A literature review

Article

Sep 2021

Magalie El Hajj

Lebanon has been under continuous conflict for more than four decades, putting millions of Lebanese at a high risk for post-traumatic stress disorder (PTSD) and creating a complex collective trauma. This paper aimed to review all studies from Lebanon reporting on PTSD in order to describe the prevalence of PTSD and its associated risk factors among Lebanese adults. A search of the MEDLINE/PubMed database was conducted in February/ March 2021 to identify research articles on PTSD in Lebanese adults. A total of 1064 articles were identified, out of which 11 articles (5875 participants) published between 2003 and 2020 were included. PTSD prevalence estimates were highly variable across the individual studies, ranging from 2 % to 98 %. Female sex, economic hardship, lower educational level, being unemployed, number of witnessed/experienced traumatic events, and presence of comorbid psychological disorders were associated with higher PTSD rates. In light of the increasing PTSD risk in the Lebanese population as a result of the recent Beirut blast and ongoing social and economic crises, further culturally competent research is needed to provide rigorous evidence on the prevalence, course, and severity of PTSD in Lebanon.

Psychological distress and neuroticism among Syrian refugee parents in post-resettlement contexts

Article

Jan 2021

Vivian Khamis

This study examined the contributions of parents’ characteristics, normative stressors, coping strategies, and social support to psychological distress and neuroticism among 1000 Syrian refugees. The conditions of being older, mothers, partnered parents, and resettlement in Lebanon increased the risk of mental health problems. Mental health problems decreased with fathers’ employment, large families, and time spent in the host country. Types of daily stressors had differential effects on psychological distress and neuroticism. While emotion-focused coping increased psychological distress and neuroticism, the use of problem-focused coping, and informational support reduced neuroticism. The clinical and policy implications of these conclusions were discussed.

Youth in Northern Ireland: Linking Violence Exposure, Emotional Insecurity, and the Political Macrosystem

Article

Full-text available

Dec 2020

Growing up in the aftermath of armed conflict puts youth at a higher risk for psychopathology—particularly in societies like Northern Ireland which continue to be characterized by intergroup tension and cyclical violence. This risk may be heightened during adolescence, when youth are beginning to explore their identities and are becoming more aware of intergroup dynamics in both their immediate communities and the broader society. It is also during this stage when youth increasingly witness or engage in antisocial behavior and sectarian activities. A series of studies in Belfast conducted by Cummings et al. (2014, Child Dev Perspect , 12(1), 16–38; 2019, J Clin Child Adolesc Psychol , 48(2), 296–305) showed that adolescents’ exposure to sectarian violence resulted in heightened emotional insecurity about the community and subsequent adjustment problems. Though the impact of direct exposure to violence is well documented, few studies have accounted for the influence of sectarianism that occurs outside of one's immediate environment. These influences may include the general climate surrounding events that are not experienced firsthand but are nonetheless salient, such as the overarching levels of tension between groups or societal discourse that is threatening to one's identity. These higher‐level influences, often referred to collectively as the macrosystem, are a necessary component to consider for adequately assessing one's socio‐developmental environment. Yet, measurement at this level of the social ecology has proven elusive in past work. The current study advances research in this area by using newspaper coding as a method of measuring the political macrosystem in Northern Ireland and assessing whether a tense or threatening climate serves as an added risk factor for youth living in Belfast. In the current study, we measured sectarian violence at the level of the macrosystem by systematically collecting and coding newspaper articles from Northern Ireland that were published between 2006 and 2011 ( N = 2,797). Each article was coded according to its level of overall political tension between Catholics and Protestants, threat to Catholics, and threat to Protestants. When aggregated, these assessments reflected the overarching trends in Catholic–Protestant relations during this period. In order to assess the association between these sociopolitical trends and the direct experiences of adolescents, the newspaper coding was linked with five waves of survey data from families ( N = 999) in socioeconomically disadvantaged areas of Belfast. Using a series of multilevel moderation analyses, we then tested whether intergroup tension and ingroup threat moderated the relation between adolescents’ direct exposure to violence and their emotional insecurity. These analyses were followed by a thematic analysis of the coded newspaper articles in order to provide further context to the findings. The results indicated that adolescents’ response to direct exposure to sectarian violence varied based on the political climate at the time of their interview. Overall, the adolescents’ emotional insecurity about the community increased with exposure to sectarian violence. During periods when the sociopolitical climate was characterized by high levels of intergroup political tension, this relation was slightly weaker—regardless of the adolescents’ ingroup (i.e., Protestant vs. Catholic). During periods when the sociopolitical climate was coded as threatening, this relation was weaker for Catholic adolescents. That is, high levels of macro‐level threat—particularly events coded as threatening for Protestants—seemed to be a protective factor for Catholic adolescents. Group differences were also found based on the adolescents’ cumulative amount of exposure to sectarian violence. As threat in the macrosystem increased, Catholic adolescents who were directly exposed to higher than average levels of sectarian violence became more emotionally secure, while Catholics with little to no exposure to violence became more insecure. Contrastingly, Protestant adolescents directly exposed to higher than average levels of sectarian violence were more insecure than Protestants with little to no violence exposure. A thematic analysis of the newspaper articles revealed the categories of events that were viewed by coders as politically tense and threatening. Five primary themes emerged: ineffective policing and justice, family and community unrest, memories of violence, destabilized leadership, and organized paramilitary activity. Many of the articles coded as most threatening reported on a spike in attacks organized by dissident republican groups—that is, members of the Catholic community with, particularly hardline views. This may be pertinent to the finding that associations between sectarian violence exposure and emotional insecurity were exacerbated during this time for Protestants but not for Catholics. Findings from the thematic analysis provide a deeper examination of the context of events taking place during the study period, as well as their potential bearing on interpretation of the macro‐level effects. In conclusion, these findings illustrate how one's response to the immediate environment can vary based on shifts in the political macrosystem. The current study thus contributes conceptually, empirically, and methodologically to the understanding of process relations between multiple levels of the social ecology and adolescent functioning. These results may further inform the design of future interventions and policies meant to lessen the impact of political violence. The methods used here may also be useful for the study of other contexts in which macrosystem effects are likely to have a salient impact on individual wellbeing.

Psychological distress and self-harm in a religiously diverse sample of Lebanese students

Article

Full-text available

Sep 2020

Drawing on identity process theory, this study explores the protective and risk factors of psychological distress and self-harm in a religiously diverse sample of heterosexual and non-heterosexual students in Lebanon. A convenience sample of 209 undergraduate students participated in a cross-sectional survey and completed measures of religiosity, identity threat, psychological distress and self-harm. Results indicated that non-heterosexual participants exhibited higher levels of psychological distress, were more likely to report self-harm, and reported lower levels of religiosity than their heterosexual counterparts. It was shown that religiosity was protective against psychological distress, and that sexual orientation distress predicted self-harm. In order to reduce the risk of psychological distress and self-harm, it will be necessary to challenge stigma towards sexual minorities, to promote engagement with a broader range of social identity categories (other than just religion), and to ensure the availability of effective counselling support to all who need it.

Politics of Interconfessional Empathy and Schadenfreude in Lebanon

Article

Full-text available

Mar 2020

We analyze the sources of two politically relevant, yet opposing emotions: empathy and Schadenfreude. We propose that group and individual-level political factors affect empathy and Schadenfreude toward other groups. Using a survey experiment conducted in Lebanon we find that, when presented with a prompt about political repression, respondents are less likely to express empathy and more likely to express Schadenfreude when victims of political repression were from the out-group perceived as their group's most recent antagonist. At the individual level, those more involved in their in-group's community are generally more likely to feel Schadenfreude and less likely to express empathy.

Traumas in childhood: War trauma

Article

Full-text available

Jan 2019

Nataša Lazović

Associations between dimensions of religiousness and psychosocial functioning among bereaved youth

Article

Full-text available

Mar 2019
DEATH STUD

Using a sample of recently bereaved youth (N = 2,425; Mage = 15.31, SD = 1.50), this study examined associations between dimensions of religiousness and current functioning. Youth reported on their religious service attendance, religious coping, and the importance of religious beliefs and substance use, academic achievement, depressive symptoms, and self-esteem. Greater religious service attendance was associated with lower substance use and the greater importance of religious beliefs was associated with lower substance use and greater self-esteem. Greater religious coping was associated with greater academic achievement. Findings suggest distinct dimensions of religiousness may have differential implications for adolescent functioning after experiencing loss.

Posttraumatic stress disorder and emotion dysregulation among Syrian refugee children and adolescents resettled in Lebanon and Jordan

Article

Mar 2019
CHILD ABUSE NEGLECT

Vivian Khamis

Background: Since the outbreak of the conflict in Syria, many people, including children and adolescents, have fled their homes into neighboring countries. Little research exists on the psychosocial adjustment of refugee children and adolescents resettled in Lebanon and Jordan. Objective: This study investigated the prevalence and predictors of PTSD and emotion dysregulation in Syrian refugee children and adolescents who resettled in Lebanon and Jordan. It was hypothesized that a combination of pre-trauma variables (age and gender), trauma-specific variables (traumatic events and time spent in host country, and host country), and post-trauma variables (coping strategies, family relationships, and school environment) would be associated with PTSD and emotion dysregulation. Participants and setting: Participants were 1000 Syrian refugee children and adolescents aged 7-18 years attending formal and non-formal schools representing various governorates in Lebanon and Jordan. Methods: The trauma exposure scale, DSM-IV criteria for the assessment of PTSD, the Difficulties in Emotion Regulation Scale Short Form, Kidcope, Family relationship scales, and school environment scale were administered in an interview format with children and adolescents at school by two trained psychologists. Multivariate binary logistic regression was used to predict PTSD whereas hierarchical multiple regression was used to predict emotion dysregulation. Results: Results indicated that 45.6% of the refugees have developed PTSD with excessive risk for comorbidity with emotion dysregulation. Emotion dysregulation was reported by older refugee children and adolescents. The prevalence of PTSD was higher in refugee children and adolescents who had resettled in Lebanon than for those who had resettled in Jordan. Refugee children and adolescents who were exposed to higher levels of war atrocities evidenced the greatest prevalence of PTSD and emotion dysregulation. PTSD symptomatology and emotion dysregulation in children and adolescents varied according to coping styles, family relationships, and school environment. Both decreased significantly with the passage of time spent in host country. Conclusions: The results may be used to formulate cognitive-behavioral coping interventions that can lead to optimal developmental outcomes in the posttrauma environment.

A Review of the Psychological Impact of the 2006 War on the Civilian Population in Lebanon

Article

Full-text available

Jan 2019
Traumatology

Joseph El-Khoury

The 2006 Lebanon war was the last major round of the various conflicts that have affected this countryfor half a century. Its nature, scope, and timing after a decade of relative peace, have had an enduring effect on the Lebanese psyche. At a time of renewed regional tension and a threat of possible military action in the same geographical area, we review the literature on the psychological impact of this war on the civilian population of the affected conflict zone. We also comment on the relative evolution of the Lebanese mental health system and the ability of Lebanon to use lessons from previous conflicts to respond in case of future mass traumatic events. The literature published immediately after the war and years later reveals higher rates of posttraumatic stress disorder, in addition to anxiety and mood disorders in all groups. Very little is known of the interventions used by the government and various organizations to address these conditions. In the absence of a national emergency response strategy, the mental well-being of war-exposed populations remains vulnerable to cumulative effects and unmet needs.

Prevalence of Mental Distress Among Syrian Refugees With Residence Permission in Germany: A Registry-Based Study

Article

Full-text available

Aug 2018

Background: High rates of prevalence of mental distress among the Syrian refugee population have been repeatedly confirmed. However, little is known about the influence of length of stay, living conditions, and residence permission in the host country or about the duration of the escape journey and travel conditions on mental health in this refugee population. This study examines the mental health of Syrian refugees, taking into account the circumstances in their country of origin and host country, as well as their escape conditions. Methods: This investigation formed part of a registry-based study. A sample of 518 adult Syrian refugees in Erlangen, Germany, who have residence permission was identified. The response rate was 38.6%; a total of 200 Syrian refugees thus participated in the study. The respondents were investigated for post-traumatic stress disorder (ETI), depression (PHQ-9), generalized anxiety (GAD-7) and post-migration variables. Results: The prevalence of participants who had personally experienced and/or witnessed traumatic events was 75.3%. Symptoms of PTSD were found in 11.4% of the participants. Moderate to severe depression was confirmed in 14.5% and moderate to severe generalized anxiety in 13.5% of the sample. The criteria for at least one diagnosis were met by 30.5% of the participants. More severe PTSD symptoms were associated with older age, shorter validity of the residence permit, larger number of traumatic events (TEs) and higher generalized anxiety symptoms. Depression symptoms were associated with younger age, shorter duration of escape journey, larger number of TEs and higher generalized anxiety symptoms. Generalized anxiety symptoms correlated with female gender, PTSD, and depression symptoms. Conclusions: These findings suggest that Syrian refugees in Germany are a vulnerable population, especially if they have experienced and/or witnessed multiple traumatic events. However, post-migration conditions and positive future prospects in the host country can be protective factors for this population.

Prevalence of mental distress in Syrian refugees with residence permission in Germany

Article

Full-text available

Jun 2018
J PSYCHOSOM RES

Author's manuscript

Data

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Aug 2017

VIOLENCE AGAINST WOMEN IN THE GAZA STRIP AFTER THE ISRAELI MILITARY OPERATION PROTECTIVE EDGE 2014

Technical Report

Full-text available

Oct 2015

Post-traumatic stress disorder in adult victims of cluster munitions in Lebanon: a 10-year longitudinal study

Article

Full-text available

Aug 2017

Objective: This study aims to explore the short-term and long-term prevalence and effects of post-traumatic stress disorder (PTSD) among victims of cluster munitions. Design and setting: A prospective 10-year longitudinal study that took place in Lebanon. Participants: Two-hundred-and-forty-four Lebanese civilian victims of submunition blasts, who were injured in 2006 and were over 18 years old, were interviewed. Included were participants who had been diagnosed with PTSD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and the PTSD Checklist - Civilian Version in 2006. Interviewees were present for the 10-year follow-up. Main outcome measures: PTSD prevalence rates of participants in 2006 and 2016 were compared. Analysis of the demographical data pertaining to the association of long-term PTSD with other variables was performed. p Values <0.05 were considered statistically significant for all analyses (95% CI). Results: All the 244 civilians injured by cluster munitions in 2006 responded, and were present for long-term follow-up in 2016. The prevalence of PTSD decreased significantly from 98% to 43% after 10 years (p<0.001). A lower long-term prevalence was significantly associated with male sex (p<0.001), family support (p<0.001) and religion (p<0.001). Hospitalisation (p=0.005) and severe functional impairment (p<0.001) post-trauma were significantly associated with increased prevalence of long-term PTSD. Symptoms of negative cognition and mood were more common in the long run. In addition, job instability was the most frequent socioeconomic repercussion among the participants (88%). Conclusions: Psychological symptoms, especially PTSD, remain high in war-affected populations many years after the war; this is particularly evident for Lebanese civilians who were victimised by cluster munitions. Screening programmes and psychological interventions need to be implemented in vulnerable populations exposed to war traumas. Officials and public health advocates should consider the socioeconomic implications, and help raise awareness against the harm induced by cluster munitions and similar weaponry.

"We must cooperate with one another against the Enemy": Agency and activism in school-aged children as protective factors against ongoing war trauma and political violence in the Gaza Strip

Article

Jul 2017

This exploratory qualitative study investigated self-perceived risk and protection factors that may reinforce the ability of children living in refugee camps on the Gaza Strip to adjust to a traumatic and risky life context characterized by loss and dispossession. The sample comprised 200 Palestinian children recruited at primary schools in four refugee camps in the Gaza Strip following the Israeli military operation "Pillar of Defence" in 2012. Thematic content analysis was applied to written materials and narratives produced by the children. Environment, friends, emotions, family, play, self, sociality, health, school, and spirituality were the dimensions that emerged from the narrative texts. Palestinian children's psychological adaptability and ability to reposition themselves along the continuum between ease and disease is underpinned by constant political agency and activism - a dimension that guides sense-making activities in a traumatizing environment marked by continuous uncertainty, loss and bereavement. We therefore recommend a politically-informed focus, both when assessing children and when designing intervention for them in contexts of chronic political violence and war.

Involvement of Adolescents in Armed Conflict

Article

Jun 2018

Gómez (2021) Tesis CrecimientoPostraumático en Victimas del Terrorismo de Estado

Thesis

Jan 2021

Mauricio C. Gómez

Cultural Responses to Collective Trauma in Different Societies Explains Aspects of Their Identity

Chapter

Jun 2022

Samuel Yaw Appiah-Marfo

Different societies have different ways through which traumatic experiences are handled. This shapes their identity. This chapter will use Eric Berne's psychotherapist transactional analysis theory to emphasize how people relate to one another and establish the extent communications influences human behaviours. The author indicates how the theory underscores societies' and individuals' representations of violent conduct by examining the traumatic experiences of some societies like the Yukpa people and the Jews during and after the Holocaust. Thematic areas will include identity and violence, trauma of war, and group construction of violence, among others. All of these themes are interconnected. Finally, the relevance of this work is to minimize interpersonal and organizational conflicts as well as promote tolerance of divergent views.

Types of Traumatic Events, Response to the Events and Coping Strategies amongst Selected Adults Resident of Internally Displaced Persons Camps in Nigeria

Article

Full-text available

Dec 2017

The return of Nigeria to Civilian rule since 1999 has witnessed the killing of thousands of people through recurring inter-communal conflicts and politically motivated violence. The forced evictions resulting from these occurrences have caused significant population movements resulting in large waves of internal displacement. Therefore, this research was aimed at evaluating types of traumatic events, response to the events, and coping strategies amongst selected Adults. Residents of internally displaced persons' camp in Nigeria. The researchers adopted cross-sectional research design with the sample size determined using Taro Yamane sample size Determination formula resulting in the selection of 392 respondent using multistage sampling technique. Four (4) research questions were answered while four (4) null hypotheses were tested. Results showed that 57.8% of respondents were males while 42.2% were females most of the respondents 51.4% are Muslims as against 43.2% who are Christians. The types of traumatic experienced by the respondents included evaluation from home which was experienced by 84.8%, followed by lack of food. In term of the way they responded to traumatic events, 13.4% experienced being jumpy. The coping style widely accepted positive reinterpretation and social support. These was a significant association between the employment status of respondents and destruction of properties. It was concluded that the internally displaced persons adopted mixture of problem focused and emotional focused coping strategies.

Coping styles in heterosexual and non-heterosexual students in Lebanon: a cross-sectional study ( Estilo de afrontamiento en estudiantes heterosexuales y no heterosexuales en Líbano: un estudio transversal )

Article

Full-text available

Jan 2022

The Lebanese population has been exposed to multiple stressors associated with political and economic instability for decades. Using survey data from 203 university students in Beirut, this study focuses on the factors that predict coping styles in men and women and heterosexual and non-heterosexual people in Lebanon. Heterosexual people reported higher religiosity and ethnic identification but lower psychological distress than non-heterosexual people. Women reported higher religiosity but lower identity resilience and engagement in the re-thinking/planning coping style than men. Religiosity was positively associated with identity resilience and ethnic identification but negatively associated with the social engagement coping style. Ethnic identification and identity resilience were positively associated with the social engagement and re-thinking/planning coping styles. Identity resilience and religiosity were negatively associated with psychological distress. The social engagement and re-thinking/planning coping styles were positively correlated. Results suggest that non-heterosexual people may be less likely to adopt adaptive coping styles because of their decreased religiosity and ethnic identification and that men and women have distinct pathways to adaptive coping strategies (through identity resilience and religiosity, respectively).

Prevalence of post-traumatic stress disorder among Palestinian children and adolescents exposed to political violence: A systematic review and meta-analysis

Article

Full-text available

Aug 2021
PLOS ONE

Objective: We undertook a systematic review of the literature to explore the prevalence of post-traumatic stress disorder (PTSD) in Palestinian children and adolescents exposed to political violence. This is the first systematic review and meta-analysis of the prevalence of PTSD in this population. Methods: PubMed, Embase, PsycInfo, Google Scholar and Cochrane library were searched until June 2020. To estimate the prevalence of PTSD, sub-group and meta-analysis were conducted. Results: The search resulted in 2786 studies, of which 28 articles representing 32 samples with a total of 15,121 participants from Gaza Strip and West Bank met either the DSM-4 or DSM-5 criteria and were included. The pooled prevalence of PTSD was 36% (95% CI 30-41%; I2 98.6%) and ranged from 6% to 70%. Sub-group analysis showed that the PTSD prevalence did not differ according to region (West Bank, Gaza Strip) and tended to decrease after including only studies using a representative sample (p<0.001), and among those with low risk of bias (p<0.001). Visual inspection of the included studies revealed significant discrepancies in study design and assessment measures. Conclusion: We identified high prevalence of PTSD among Palestinian children and adolescents exposed to political violence. However, the pooled results should be interpreted with caution, due to the high heterogeneity and risk of bias in the included studies. These limitations also reflect the challenge in conceptualizing and measuring PTSD in the Palestinian context with a background of continuous and cumulative trauma. Understanding the contextual factors and developing locally adapted survey measures are of relevance to future research, public health planning, and the provision of mental healthcare in Palestine.

Trauma exposure and post-traumatic stress symptoms among Syrian refugee youth in Jordan: Social support and gender as moderators: TRAUMA AND PTS SYMPTOMS IN REFUGEE YOUTH

Article

Full-text available

Jun 2020

This study assessed relations between exposure to trauma and post‐traumatic stress (PTS) symptoms, and whether perceived social support from family and friends and gender moderated these associations. Syrian refugee youth (N = 418, 55.0% female) attending public schools in Jordan participated. Boys reported more age‐adjusted PTS symptoms than girls. Analyses revealed that family support and gender moderated the association of trauma on PTS symptoms. For males, the benefits of family support were most evident under conditions of high traumatic stress exposure, while for females, benefits of family support were evident when no loss or injury to family members had been reported. Support from friends was not helpful for either gender. School‐ or family‐based interventions designed to treat PTS symptoms need to consider the different needs of boys and girls, particularly within the Syrian Muslim cultural context.

Religiosity and the psychological outcomes of trauma: A systematic review of quantitative studies

Article

Sep 2019

Justyna Kucharska

Objective: This is a broad review examining the relationships between religiosity and the psychological outcomes of trauma. Previous studies showed that some constructs of religiosity are associated with lower severity of symptoms of mental disorders, whereas others, for instance, negative religious coping, predict deteriorated mental health. Method: A systematic review of peer-reviewed quantitative studies was conducted to examine the patterns of relationships between religiosity and psychological outcomes of trauma, potential causal relationships, and specific effect of religiosity on the outcomes on trauma. Results: A total of 79 quantitative studies were included. The majority focused on military trauma or various types of traumatic exposure in the general population. Most of the studies employed a cross-sectional design. Conclusions: The associations between religiosity and psychological outcomes of trauma depend on the concept of religion used in a study, type of trauma. There is not enough evidence to support the causal effect of religiosity.

Determination of psychosocial conditions of refugee children living in society

Article

Full-text available

Apr 2019

Purpose This study aims to determine the psychosocial conditions of refugee children living in society. Designs and Methods This descriptive cross‐sectional research which used the Socio‐demographic Information Form for Children, Child Posttraumatic Stress Reaction Index (CPTS‐RI), and Children's Depression Inventory (CDI) included 738 children. Results Social factors like the educational levels and professions of their parents, as well as economic status could affect the children's level of posttraumatic stress disorder, depression, and anxiety. The regression analysis revealed that depression and anxiety explained 72% of posttraumatic stress disorder in the children studied. Practice Implications Nurses should be aware that the effects of trauma on children who were exposed to war and migration can continue even after much time has passed since the war started.

Religiosity: Protective or Risk Factor for Posttraumatic Distress Among Adolescents Who Were Exposed to Different Types of Acts of Political Violence

Article

Jun 2018

This study examined the potential moderating effects of religiosity on the associations between exposure to acts of political violence and posttraumatic stress symptoms (PTS) among Jewish adolescents in Israel. In addition, it examined whether self-reported physical and interpersonal exposure to acts of political violence predicts PTS symptoms beyond the objective exposure effects (i.e., the proximity of participants’ place of residence to high-, moderate-, or low-intensity political violence). A representative sample of 2,992 Jewish high school students (Grades 10 and 11) was taken. We used self-reporting to measure the level of religiosity and the Impact of Events Scale–Revised (IES-R) to measure PTS symptoms. Results show that self-reported exposure to acts of political violence adds a significant additional amount of variance to the prediction of PTS symptoms after objective exposure is already included in the regression equation. Religiosity was found as a risk factor for PTS symptoms such that the greater the religiosity of the adolescents, the higher their PTS symptoms. Therefore, prevention interventions should target the vulnerable group of religious Jewish adolescents.

Why Are Some Individuals More Resilient Than Others: The Dynamic Role of Social Support and Religious Coping in Predicting PTSD and Psychiatric Distress as a Result of Mass Trauma

Article

Full-text available

May 2016

Fuaad Freh

There has been little reported research into the effect of mass trauma and the dynamic role of coping strategies among young adults in Iraq. This study investigated the prevalence of post-traumatic stress disorder (PTSD) and psychiatric distress. It also examined the role of social support and religious coping strategies in predicting identified mental health outcomes. A total of 208 Iraqi students with a mean age of 20.26 years were sampled, and were assessed using the PTSD inventory, General Health Questionnaire (GHQ-28), The Crisis Social Support (CSS), and the Brief Arab Religious Coping Scale (BARCS). The results showed that 68.7% of the participants reported symptoms consisted with a diagnosed of current probable PTSD related to the attack, and 87.9% scored at or above the cut-off point of 4, thus fulfilling the criteria for psychiatric distress. For the cross-sectional analysis, the presence of PTSD and psychiatric distress were predicted significantly by level of exposure to bombing, low levels of social support and religious coping. These findings underscore the role of interpersonal resources in the psychological sequelae of exposure to a continuous, life-threatening situation by highlighting the significant role played by perceived social support and religious beliefs among individuals exposed to bombing attacks. The clinical and research implications of the findings are discussed.

Common Topics of Sociology of Religion in Non-Religion-Specific Journal Articles

Article

Jul 2017

Janos Toth

In this study, I analyze the main topics and results introduced in recent publications in the sociology of religion. Briefly touching upon the practical use of identification of major topics covered in published literature during the process of publication output planning, we continue the article with the thematical analysis of those journal articles in the sociology of religion, in which the presented research did not focus on a specific religion or on the believers of a specific religion. We examined the adherence to this criterion of lack of specification in 173 articles published in leading international journals between 2010 and 2013, from the journal list of the Institute of Sociology of the HAS (Hungarian Academy of Sciences), from which 66 journal articles were coded and classified with inductive categorization consistent with grounded theory. Throughout the process, we managed to identify 6 main topics (Secularization, Economy, Sexuality, Politics, Personal Satisfaction, and Well-Being, Social CoExistence, and Cooperation). We then further divided each of these key themes into subtopics, and we examined the studies further, according to the institutional affiliation of first author(s), institutional affiliation of journal editors, and geographic location of journal publishers. Results show that the identified topics and topic preferences are characteristics of a subset of a Western sociological knowledge, produced mainly by agents embedded in an Anglo-Saxon research environment.

Tier 2: Cross-Sectional Studies of Mediators, Process-Oriented Moderators, and Social-Ecological Contexts

Chapter

Mar 2017

Research meeting criteria for Tier 2 expands beyond Tier 1 by exploring the processes that moderate and/or mediate the effects of political violence and armed conflict on youth adjustment in multiple contexts worldwide. This research thus provides an important source of hypotheses and directions for future research about factors that may explain child outcomes, including study of the effects on youth functioning in the contexts of the family, school, community, and culture, that is, multiple levels of the social ecology. In this chapter, we discuss noteworthy findings and patterns of research designs from this body of work. This work highlights the importance of different levels of the social ecology in influencing child outcomes, including the role of individual characteristics and social-ecological factors (i.e., family, school, and community). We provide t extensive information on a diverse, noteworthy group of Tier 2 studies in Table 4. 1, providing a valuable, handy reference for a group of the best studies at this level of investigation (e.g., region sampled, assessment timing, participants sampled, measures, and major findings).

War Zone Stress, Personal Resources, and PTSD in Persian Gulf War Returnees

Article

Full-text available

Aug 1995

Posttraumatic stress disorder (PTSD) can occur subsequent to war stress, but not all troops are negatively affected. A discriminant function model was used to study associations between personal and environmental resources and psychological outcomes subsequent to war zone stress. Among 775 Persian Gulf War exposed troops, 2 subsets were identified: 97 with PTSD diagnoses and 484 who had no psychological distress. A discriminant function, double cross-validated in random subsamples, classified 87% of troops, and demographic and stress severity variables did not alter results significantly. Personality hardiness commitment, avoidance coping, and perceived family cohesion emerged as consistent predictors of PTSD diagnosis. Findings suggest personal characteristics and environmental factors may alter vulnerability to negative war stress outcomes. Work is needed to identify mechanisms and causal pathways by which resource factors enhance or lower stress resistance.

The Role of Religion in Medical Rehabilitation Outcomes: A Longitudinal Study

Article

Full-text available

Nov 1999

Objective: To investigate the protective and consolation models of the relationship between religion and health outcomes in medical rehabilitation patients. Design: Longitudinal study, data collected at admission, discharge, and 4 months postadmission. Measures: Religion measures were public and private religiosity, acceptance, positive and negative religious coping, and spiritual injury. Outcomes were self-report of activities of daily living (ADL), mobility, general health, depression, and life satisfaction. Participants: 96 medical rehabilitation inpatients; diagnoses included joint replacement, amputation, stroke, and other conditions. Results: The protective model of the relationship between religion and health was not supported; only limited support was found for the consolation model. In regression analyses, negative religious coping accounted for significant variance in follow-up ADL (5%) over and above that accounted for by admission ADL, depression, social support, and demographic variables. Subsequent item analysis indicated that anger with God explained more variance (9%) than the full negative religious coping scale. Conclusions: Religion did not promote better recovery or adjustment… (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Religion as a Meaning‐Making Framework in Coping with Life Stress

Article

Full-text available

Nov 2005
J SOC ISSUES

Crystal L Park

This article explores how religion, as a meaning system, influences coping with adversity. First, a model emphasizing the role of meaning making in coping is presented. Next, religion as a meaning system is defined, and theory and research on the role of religion in the coping process are summarized. Results from the author's study of 169 bereaved college students are then presented to illustrate some of the pathways through which religious meaning can influence the coping process in making meaning following loss. Findings indicate that associations between religion and adjustment vary across time since loss, and that these associations are mediated by meaning-making coping. Finally, implications for individual and societal well-being and suggestions for future research are discussed.

Post-traumatic stress and psychiatric disorders in Palestinian adolescents following intifada-related injuries

Article

Full-text available

Oct 2008

Vivian Khamis

This study was designed to assess the occurrence of post-traumatic stress disorder (PTSD) and psychiatric disorders (i.e., anxiety and depression) in Palestinian adolescents following intifada-related injuries. It was hypothesized that a combination of pre-trauma variables (e.g., age, geographic location), trauma-specific variables such as trauma recency, type of trauma (deliberately violent vs. accidental), and post-trauma variables (e.g., social support, coping strategies, belief in fate) would be predictive of these psychological sequelae. The participants were 179 boys who were injured during Al-Aqsa intifada and as a result sustained a permanent physical disability. They ranged in age from 12 to 18 years (M=16.30, SD=1.64). Questionnaires were administered in an interview format with adolescents at home. Approximately 76.5% of the injured victims qualify as having PTSD and that the disorder had a heterogeneous course, with excess risk for chronic symptoms and comorbidity with other psychiatric disorders such as anxiety and depression. Among all the predictors in the PTSD, anxiety and depression models, only geographical location, fatalism, and negative coping were significant predictors. In conclusion, post-traumatic reactions and psychiatric disorders in adolescents involved in armed conflict injuries can persist for several months. Given the apparent significant relationship between psychological sequelae of intifada-related injuries and certain predictors (i.e., negative coping style and fatalism), treatments such as trauma-focused cognitive behaviour therapy may yield positive results. Negative coping and fatalism should be addressed more directly during therapy.

Association of Torture and Other Potentially Traumatic Events With Mental Health Outcomes Among Populations Exposed to Mass Conflict and Displacement: A Systematic Review and Meta-analysis

Article

Full-text available

Aug 2009
J Am Med Assoc

Uncertainties continue about the roles that methodological factors and key risk factors, particularly torture and other potentially traumatic events (PTEs), play in the variation of reported prevalence rates of posttraumatic stress disorder (PTSD) and depression across epidemiologic surveys among postconflict populations worldwide. To undertake a systematic review and meta-regression of the prevalence rates of PTSD and depression in the refugee and postconflict mental health field. An initial pool of 5904 articles, identified through MEDLINE, PsycINFO and PILOTS, of surveys involving refugee, conflict-affected populations, or both, published in English-language journals between 1980 and May 2009. Surveys were limited to those of adult populations (n > or = 50) reporting PTSD prevalence, depression prevalence, or both. Excluded surveys comprised patients, war veterans, and civilian populations (nonrefugees/asylum seekers) from high-income countries exposed to terrorist attacks or involved in distal conflicts (> or = 25 years). Methodological factors (response rate, sample size and design, diagnostic method) and substantive factors (sociodemographics, place of survey, torture and other PTEs, Political Terror Scale score, residency status, time since conflict). A total of 161 articles reporting results of 181 surveys comprising 81,866 refugees and other conflict-affected persons from 40 countries were identified. Rates of reported PTSD and depression showed large intersurvey variability (0%-99% and 3%-85.5%, respectively). The unadjusted weighted prevalence rate reported across all surveys for PTSD was 30.6% (95% CI, 26.3%-35.2%) and for depression was 30.8% (95% CI, 26.3%-35.6%). Methodological factors accounted for 12.9% and 27.7% PTSD and depression, respectively. Nonrandom sampling, small sample sizes, and self-report questionnaires were associated with higher rates of mental disorder. Adjusting for methodological factors, reported torture (Delta total R(2) between base methodological model and base model + substantive factor [DeltaR(2)] = 23.6%; OR, 2.01; 95% CI, 1.52-2.65) emerged as the strongest factor associated with PTSD, followed by cumulative exposure to PTEs (DeltaR(2) = 10.8%; OR, 1.52; 95% CI, 1.21-1.91), time since conflict (DeltaR(2) = 10%; OR, 0.77; 95% CI, 0.66-0.91), and assessed level of political terror (DeltaR(2) = 3.5%; OR, 1.60; 95% CI, 1.03-2.50). For depression, significant factors were number of PTEs (DeltaR(2) = 22.0%; OR, 1.64; 95% CI, 1.39-1.93), time since conflict (DeltaR(2) = 21.9%; OR, 0.80; 95% CI, 0.69-0.93), reported torture (DeltaR(2) = 11.4%; OR, 1.48; 95% CI, 1.07-2.04), and residency status (DeltaR(2) = 5.0%; OR, 1.30; 95% CI, 1.07-1.57). Methodological factors and substantive population risk factors, such as exposure to torture and other PTEs, after adjusting for methodological factors account for higher rates of reported prevalence of PTSD and depression.

Dispositional and situational coping and mental health among Palestinian political ex-prisoners

Article

Full-text available

Nov 2008
ANXIETY STRESS COPIN

We examined, first, differences in dispositional and situational coping, and psychological distress between political ex-prisoners and their matched controls, and second, coping effectiveness in protecting mental health from impacts of imprisonment and military trauma. Thirdly, we tested the hypothesis that compatibility ("goodness of fit") between dispositional and situational coping would predict low psychological distress. Participants were 184 men recruited from a Palestinian community sample, 92 were former political prisoners and 92 non-prisoners. The dispositional coping was assessed as a general response style to hypothetical stressors and situational coping as responses to their own traumatic experiences. Psychological distress was measured by SCL-90-R, and posttraumatic stress disorder, depression and somatoform symptoms by scales based on CIDI 2.1 diagnostic interview. The results showed that, compared to non-prisoners, the political ex-prisoners employed less avoidant, denying, and emotion-focused coping strategies. Military trauma was associated with avoidant and denying coping only among non-prisoners. The ex-prisoners showed more mental health and medical problems, especially when exposed to military trauma. None of the coping styles or strategies were effective in protecting the mental health in general or in either groups. However, main effect results revealed that the high level of active and constructive and low level of emotion-focused coping were associated with low levels of psychiatric symptoms and psychological distress.

Child Witnesses to Domestic Violence: A Meta-Analytic Review

Article

Full-text available

Apr 2003

This meta-analysis examined 118 studies of the psychosocial outcomes of children exposed to interparental violence. Correlational studies showed a significant association between exposure and child problems (d = -0.29). Group comparison studies showed that witnesses had significantly worse outcomes relative to nonwitnesses (d = -0.40) and children from verbally aggressive homes (d = -0.28). but witnesses' outcomes were not significantly different from those of physically abused children (d = 0.15) or physically abused witnesses (d = 0.13). Several methodological variables moderated these results. Similar effects were found across a range of outcomes, with slight evidence for greater risk among preschoolers. Recommendations for future research are made, taking into account practical and theoretical issues in this area.

Religiousness and Depression: Evidence for a Main Effect and the Moderating Influence of Stressful Life Events

Article

Full-text available

Jul 2003

The association between religiousness and depressive symptoms was examined with meta-analytic methods across 147 independent investigations (N = 98,975). Across all studies, the correlation between religiousness and depressive symptoms was -.096, indicating that greater religiousness is mildly associated with fewer symptoms. The results were not moderated by gender, age, or ethnicity, but the religiousness-depression association was stronger in studies involving people who were undergoing stress due to recent life events. The results were also moderated by the type of measure of religiousness used in the study, with extrinsic religious orientation and negative religious coping (e.g., avoiding difficulties through religious activities, blaming God for difficulties) associated with higher levels of depressive symptoms, the opposite direction of the overall findings.

Comorbidity of PTSD and depression refuge children during war conflict

Article

Full-text available

Apr 2004

We examined the prevalence and nature of comorbid post-traumatic stress reactions and depressive symptoms, and the impact of exposure to traumatic events on both types of psychopathology, among Palestinian children during war conflict in the region. The 403 children aged 9-15 years, who lived in four refugee camps, were assessed by completing the Gaza Traumatic Events Checklist, the Child Post Traumatic Stress Reaction Index (CPTSD-RI), and the Short Mood and Feelings Questionnaire (MFQ). Children reported experiencing a wide range of traumatic events, both direct experience of violence and through the media. CPTSD-RI and MFQ scores were significantly correlated. Both CPTSD-RI and MFQ scores were independently predicted by the number of experienced traumatic events, and this association remained after adjusting for socioeconomic variables. Exposure to traumatic events strongly predicted MFQ scores while controlling for CPTSD-RI scores. In contrast, the association between traumatic events and CPTSD-RI scores, while controlling for MFQ scores, was weak. The CPTSD-RI items whose frequency was significantly associated with total MFQ scores were: sleep disturbance, somatic complaints, constricted affect, impulse control, and difficulties in concentration. However, not all remaining CPTSD-RI items were significantly associated with exposure to traumatic events, thus raising the possibility that the association between depression and PTSD was due in part to symptom overlap. Children living in war zones are at high risk of suffering from PTSD and depressive disorders. Exposure to trauma was not found to have a unique association with PTSD. The relationship between PTSD and depressive symptomatology requires further investigation.

Post-traumatic stress disorder among school age Palestinian children

Article

Full-text available

Feb 2005
CHILD ABUSE NEGLECT

Vivian Khamis

This study was designed to assess the prevalence of PTSD among Palestinian school-age children. Variables that distinguish PTSD and non-PTSD children were examined, including child characteristics, socioeconomic status, family environment, and parental style of influence. Participants were 1,000 children aged 12 to 16 years. They were selected from governmental, private, and United Nations Relief Work Agency (UNRWA) schools in East Jerusalem and various governorates in the West Bank. Questionnaires were administered in an interview format with children at school, and with the available parent at home. A substantial number of children experienced at least one lifetime trauma (54.7%). Post-traumatic stress disorder (PTSD) was diagnosed in 34.1% of the children, most of whom were refugees, males, and working. Although the expected association between family environment, parental style of influence and PTSD symptomatoplogy was found in this study, family ambiance (child's experience of anxiety in home environment) was the only predictor in the final model. The results stress the importance of assessing PTSD in schools settings.

Posttraumatic Stress and Depressive Reactions Among Children and Adolescents After the 1999 Earthquake in Ano Liosia, Greece

Article

Full-text available

Apr 2005

This study evaluated the severity of posttraumatic stress and depressive reactions among children and adolescents 3 months after the 1999 earthquake in Ano Liosia, Greece, and additionally assessed the relationship of these reactions to objective and subjective features of earthquake exposure, sex, school level, postearthquake difficulties, death of a family member, and thoughts of revenge. This school-based study of 1,937 students was conducted in two differentially exposed cities (Ano Liosia, at the epicenter, and Dafni, 10 kilometers from the epicenter) with an earthquake exposure questionnaire, the UCLA Posttraumatic Stress Disorder (PTSD) Reaction Index, and the Depression Self-Rating Scale. Endorsement of earthquake-related exposure items between the two cities was congruent with the extent of earthquake impact in each city. Median PTSD Reaction Index scores were significantly higher in Ano Liosia. The estimated rates of PTSD and clinical depression for both cities combined were 4.5% and 13.9%, respectively. Depression, subjective and objective earthquake-related experiences, and difficulties at home accounted for 41% of the variance in severity of PTSD reactions. PTSD score was the single most powerful variable predicting depression (36% of the variance), with only sex making a small but significant additional contribution. This study demonstrated the feasibility of conducting large-scale school-based postdisaster mental health screening for planning intervention strategies. The present findings regarding PTSD and depression indicate the need to provide targeted specialized postdisaster mental health services to subgroups with significant levels of posttraumatic stress and depressive reactions after an earthquake of moderate intensity.

Ideological Commitment and Posttraumatic Stress in Former Tamil Child Soldiers

Article

Full-text available

Jan 2006

This study focuses on the impact of present ideological commitment on posttraumatic stress symptoms in former child soldiers living in exile. Eighteen men and two women (aged 25-37), who had joined different Tamil armed groups in Sri Lanka between the ages of 13 and 17 years, participated. The Impact of Event Scale was used to measure posttraumatic symptoms. Qualitative methods were used to investigate the participants' ideological commitment. Participants reported being exposed to many potentially traumatizing events, and had high scores on the Impact of Event Scale. Twenty-five percent of the sample showed strong ideological commitment to the "cause". Ideological commitment at the present seemed to predict better mental health when exposure was less intense and overwhelming. Time had a negative impact on ideological commitment.

The impact of structured activities among Palestinian children in a time of conflict

Article

Full-text available

Jan 2007

Background: There is growing evidence of the impact on children's well-being of exposure to political conflict in such settings as the Palestinian territories. This study examined the impact of child-focused interventions involving structured activities, supported by provision of equipment and training of facilitators. The focus of interventions was participation in recreational, cultural and other non-formal activities supporting the development of resilience. Impacts were hypothesised on children's social and emotional well-being, relationships with parents and degree of future orientation. Methods: Two hundred and fifty children from the West Bank and 150 children from Gaza took part in the study. Of these 400 children, 300 comprised the intervention group. Fifty children from Gaza and 50 children from the West Bank comprised the comparison group. There were equal numbers of girls and boys in all groups, with similar proportions of children aged between 6 and 11 years, and between 12 and 17 years. Measures used were the Child Behavior Checklist (CBCL), the Parental Support Scale and the Hopefulness Scale: Youth Version. Assessment was made as children enrolled on the structured activity programmes (T1) and again twelve months later (T2). Results: There was no difference in the CBCL Total, Internalising or Externalising problem scores at baseline (Time 1) between the children who subsequently took the intervention and those who did not. Compared to children in the comparison group, children in the intervention group had lower CBCL total problem scores, externalising problem scores, and internalising problem scores at Time 2 compared to Time 1. Exposure to the intervention was not associated with changes in children's hopefulness, but those receiving the intervention in the West Bank did report improved parental support at Time 2. Conclusions: The intervention appeared successful in improving children's emotional and behavioural well-being but not hopefulness. It was also linked with increased parental support in some areas (those located in the West Bank).

Prevalence of Psychiatric Disorders Among Children of Different Ethnic Origin

Article

Full-text available

Sep 2007

The present study assesses the population prevalence of DSM-IV disorders among native and immigrant children living in low socio-economic status (SES) inner-city neighborhoods in the Netherlands. In the first phase of a two-phase epidemiological design, teachers screened an ethnically diverse sample of 2041 children aged 6-10 years using the Strengths and Difficulties Questionnaire (SDQ). In the second phase, a subsample of 253 children was psychiatrically examined, while their parents were interviewed. In addition, teachers completed a short questionnaire about 10 DSM-IV items. Prevalence was estimated using the best-estimate diagnosis based on parent, child and teacher information. Projected to the total population, 11% of the children had one or more impairing psychiatric disorders, which did not differ between native and non-native children. In the total group a clear relationship was observed between the prevalence of psychiatric disorders and gender, parental psychopathology, peer problems and school problems, but not among all ethnic groups separately. This study suggests that the prevalence of psychiatric disorders among non-treated minority and native children in low SES inner-city neighborhoods does not materially differ. However, associated mechanisms may be influenced by ethnicity.

The Political Ideology of Hamas: A Grassroots Perspective

Book

Jan 2009

Michael Irving Jensen

Children's Manifest Anxiety Scale

Chapter

Jul 2008

Cecil R Reynolds

This article has no abstract.

Religious and spiritual struggles

Article

Jan 2013

The longitudinal course of posttraumatic stress disorder

Article

Jan 1993

A.S. Blank

Martyrdom in Islam

Article

Jan 2007

David Cook

In recent times Islamic martyrdom has become associated with suicide missions conducted by extremists. However, as David Cook demonstrates, this type of martyrdom is very different from the classical definition, which condemned suicide and stipulated that anyone who died as a believer could be considered a martyr. Ideas about martyrdom have evolved to suit prevailing circumstances, and it is the evolution of these different interpretations that Cook charts in this fascinating history of the role of suffering and people's willingness to die as a testimony to their faith. The book covers the earliest sources, including those from the Jewish and Christian traditions, discussions about what constituted martyrdom, differences in attitudes between Sunnis and Shi'ites, the role of martyrdom in conversion and the literary manifestations of romantic martyrdom. A concluding section discusses martyrdom in today's radical environment. There is no other book which considers the topic so systematically, and which draws so extensively on the Arabic and Persian sources, as well as on Muslim literature from across the world. This will be essential reading for students of Islamic history, and for those looking for an informed account of this controversial topic.

Epidemiologic Research (Principles and Quantitative Methods)

Article

Sep 1983

Stepwise logistic regression. Applied logistic regression

Article

Jan 2000

Youth: Fidelity and Diversity

Article

Jan 1962

Erik H. Erikson

The subject of this paper is a certain strength inherent in the age of youth. I call it the sense of and the capacity for Fidelity. Such a strength, to me, is not a moral trait to be acquired by individual effort. Rather, I believe it to be part of the human equipment evolved with socio-genetic evolution. This assertion I could not undertake to defend here; nor could I make plausible the fact that, in the schedule of individual growth, Fidelity could not mature earlier in life and must not, in the crises of youth, fail its time of ascendance if human adaptation is to remain intact. Nor (to complete the list of limitations) could I review the other stages of life and the specific strengths and weaknesses contributed by each to man’s precarious adaptation. We can take only a brief look at the stage of life which immediately precedes youth, the school age, and then turn to youth itself. I regret this; for even as one can understand oneself only by looking at and away from oneself, one can recognize the meaning of a stage only by studying it in the context of all the others.

An Inventory for Measuring Depression

Article

Jun 1961
ARCH GEN PSYCHIAT

A.T. Beck

The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out by a number of authors. Pasamanick12 in a recent article viewed the low interclinician agreement on diagnosis as an indictment of the present state of psychiatry and called for "the development of objective, measurable and verifiable criteria of classification based not on personal or parochial considerations, but on behavioral and other objectively measurable manifestations."Attempts by other investigators to subject clinical observations and judgments to objective measurement have resulted in a wide variety of psychiatric rating scales.4,15 These have been well summarized in a review article by Lorr11 on "Rating Scales and Check Lists for the Evaluation of Psychopathology." In the area of psychological testing, a variety of paper-and-pencil tests have been devised for the purpose of measuring specific

The Stress-Buffering Role of Spiritual Support: Cross-Sectional and Prospective Investigations

Article

Sep 1989

Kenneth I. Maton

The contribution of spiritual support (perceived support from God) to well-being, especially under conditions of high versus low life stress, has received little empirical study. In the present research, the relationship of spiritual support to well-being for several high and low life-stress samples was examined. With demographic variables controlled, regression analyses indicated that spiritual support: 1) was inversely related to depression and positively related to self-esteem for high life-stress (recently bereaved) parents; and 2) in a prospective (longitudinal) analysis with pre-college depression controlled, spiritual support was positively related to personal-emotional adjustment to college for high life-stress (three or more life events), first-semester college freshmen. Spiritual support was not significantly related to well-being for low life-stress subsamples. The implications of the findings for future research and intervention are discussed.

Identity, Youth, and Crisis

Book

Jan 1968

Erik Homburger Erikson

Can Ideological Commitment Protect Children's Psychosocial Well-Being in Situations of Political Violence?

Article

Feb 1996

Raija-Leena Punamäki

The mental health role of ideological commitment (operationalized as glorification of war, patriotic involvement, and defiant attitudes toward the enemy) was studied among 385 Israeli girls and boys (mean age 12 ± 2.50). It was hypothesized that experiences of political hardships do not increase psychosocial problems if children have strong ideological commitment. The hypothesis was conditionally substantiated concerning symptoms of anxiety and insecurity, and depression and feelings of failure. Exposure to political hardships did not increase the presence of these symptoms among children who showed strong ideological commitment. In contrast, among children with weak ideological commitment, exposure increased these symptoms, but not linearily. Furthermore, injury and loss decreased social support if children showed weak ideological commitment. There was also the mediating role of ideological commitment, showing that political hardships increased the ideological commitment that, in turn, was related to a low level of psychosocial problems.

Applied Logistic Regressio

Book

Oct 2004

From the reviews of the First Edition."An interesting, useful, and well-written book on logistic regression models . . . Hosmer and Lemeshow have used very little mathematics, have presented difficult concepts heuristically and through illustrative examples, and have included references."—Choice"Well written, clearly organized, and comprehensive . . . the authors carefully walk the reader through the estimation of interpretation of coefficients from a wide variety of logistic regression models . . . their careful explication of the quantitative re-expression of coefficients from these various models is excellent."—Contemporary Sociology"An extremely well-written book that will certainly prove an invaluable acquisition to the practicing statistician who finds other literature on analysis of discrete data hard to follow or heavily theoretical."—The StatisticianIn this revised and updated edition of their popular book, David Hosmer and Stanley Lemeshow continue to provide an amazingly accessible introduction to the logistic regression model while incorporating advances of the last decade, including a variety of software packages for the analysis of data sets. Hosmer and Lemeshow extend the discussion from biostatistics and epidemiology to cutting-edge applications in data mining and machine learning, guiding readers step-by-step through the use of modeling techniques for dichotomous data in diverse fields. Ample new topics and expanded discussions of existing material are accompanied by a wealth of real-world examples-with extensive data sets available over the Internet.

Political Violence and the Palestinian Family: Implications for Mental Health and Well-Being

Book

Jan 2000

Vivian Khamis

Conservative Shift Among High-Exposure Survivors of the September 11th Terrorist Attacks

Article

Dec 2006

Potentially traumatic events evoke a wide range of responses and outcomes. From a motivated so- cial cognitive approach to ideology, system-threatening events such as 9/11 should increase psy- chological needs to manage uncertainty and threat and, therefore, the appeal of politically conser- vative opinions. We investigated "conservative shift" among high-exposure survivors of the 9/11 terrorist attacks (n = 45) and its relationship to coping and adjustment. Results indicated that Democrats and Independents (as well as Republicans) were more likely to shift toward conserva- tism and away from liberalism following 9/11. Despite its prevalence, we found relatively little evidence that embracing conservatism was related to improved well-being as measured either in terms of survivors' mental health symptoms or friends-relatives' ratings of their psychological adjustment. On the contrary, political conservatism, right-wing authoritarianism, and conserva- tive shift were generally associated with the following: chronically elevated levels of posttraumatic stress disorder (PTSD) and depression, desire for revenge and militarism, cyni- cism, and decreased use of humor. Conservative shift was also associated with increased religios- ity, patriotism, and the perception that the events of 9/11 created new interests and opportunities, suggesting that it may contain some adaptive (as well as maladaptive) features.

Patterns of Positive and Negative Religious Coping with Major Life Stressors

Article

Apr 1998

This study attempted to identify positive and negative patterns of religious coping methods, develop a brief measure of these religious coping patterns, and examine their implications for health and adjustment. Through exploratory and confirmatory factor analyses. positive and negative religious coping patterns were identified in samples of people coping with the Oklahoma City bombing, college students coping with major life stressors, and elderly hospitalized patients coping with serious medical illnesses. A 14-item measure of positive and negative patterns of religious coping methods (Brief RCOPE) was constructed. The positive pattern consisted of religious forgiveness, seeking spiritual support, collaborative religious coping, spiritual connection, religious purification, and benevolent religious reappraisal. The negative pattern was defined by spiritual discontent, punishing God reappraisals, interpersonal religious discontent. demonic reappraisal, and reappraisal of God's powers. As predicted, people made more use of the positive than the negative religious coping methods. Furthermore, the two patterns had different implications for health and adjustment. The Brief RCOPE offers an efficient, theoretically meaningful way to integrate religious dimensions into models and studies of stress, coping, and health.

Patterns of Positive and Negative Religious Coping with Major Life Stressors

Article

Apr 1998
J SCI STUD RELIG

This study attempted to identify positive and negative patterns of religious coping methods, develop a brief measure of these religious coping patterns, and examine their implications for health and adjustment. Through exploratory and confirmatory factor analyses, positive and negative religious coping patterns were identified in samples of people coping with the Oklahoma City bombing, college students coping with major life stressors, and elderly hospitalized patients coping with serious medical illnesses. A 14-item measure of positive and negative patterns of religious coping methods (Brief RCOPE) was constructed. The positive pattern consisted of religious forgiveness, seeking spiritual support, collaborative religious coping, spiritual connection, religious purification, and benevolent religious reappraisal. The negative pattern was defined by spiritual discontent, punishing God reappraisals, interpersonal religious discontent, demonic reappraisal, and reappraisal of God's powers. As predicted, people made more use of the positive than the negative religious coping methods. Furthermore, the two patterns had different implications for health and adjustment. The Brief RCOPE offers an efficient, theoretically meaningful way to integrate religious dimensions into models and studies of stress, coping, and health.

Widowhood, Religiousness, and Self-Assessed Well-Being Among Older Adults

Article

Aug 2007

Background: The well-being of older, widowed persons is of concern to aging practitioners, including those in faith-based organizations. Some have suggested that engaging in religious/spiritual activities may mitigate the negative effects of widowhood for older adults. This cross-sectional study examined predictors of self-assessed well-being of widowed and married elders. The aim of this study was to determine whether participation in religious/spiritual activities mediated the relationship between marital status and well-being after controls were instituted.Method: This study is a secondary analysis of data collected for the National Opinion Research Center's 1998 General Social Survey. Analyses are based on 150 married and 120 widowed persons aged 60 or older. We regressed married/widowed status, demographic characteristics, self-reported health, and four measures of religious/spiritual activity on a fouritem index of self-assessed well-being.Results: Widowed elders reported lower levels of well-being than married elders, even after we controlled for sociodemographic characteristics, self-perceived health, and measures of religious/spiritual activity. Socioeconomic status (SES) and self-perceived health had positive relationships with well-being, and frequency of prayer had a negative relationship with well-being.Conclusion: Congregations wishing to improve well-being among widowed and married elders should consider focusing on ministries to improve financial well-being and health and advocacy for programs that benefit low income elders. Church-based programs targeting widowed elders should focus on positive religious coping and prayer.

Disease, Pain and Sacrifice: Toward a Psychology of Suffering

Article

Jan 1968

DAVID BAKAN

AN EXAMINATION OF SUFFERING AND ITS BIOLOGICAL, PSYCHOLOGICAL, AND EXISTENTIAL ASPECTS. THE 1ST SECTION DISCUSSES DISEASE AND ITS CONNECTION WITH SEPARATION-ESTRANGEMENT. THE "DOCTRINE OF SPECIFIC ETIOLOGY" IS QUESTIONED, AND IT IS THEORIZED (BASED ON HANS SELYE) THAT "DISEASE IS TO BE CONCEIVED OF AS DECENTRALIZATION OF THIS HIGHER TELOS . . . " OR TELIC DECENTRALIZATION. THIS BIOLOGICAL DECENTRALIZATION IS RELATED TO THE PSYCHOLOGICAL STATE OF THE ORGANISM AND PAIN IS ANALYZED FROM A PHENOMENOLOGICAL VIEWPOINT. THE FINAL CHAPTER IS AN EXISTENTIAL APPROACH TO THE SUFFERING OF JOB. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Children and Politics: An Empirical Reassessment of Early Political Socialization

Article

Nov 2010
POLIT PSYCHOL

Demands for the inclusion of children, the youngest citizens, in democratic decision making are increasing. Although there is an abundance of empirical research on the political orientations of adolescents, there is a paucity of research on younger children's orientations. Our panel study of more than 700 children in their first year of primary school shows that these young children already exhibit consistent, structured political orientations. We examine the distribution and development of political knowledge, issue orientations, and notions of good citizenship. We find achievement differences between subgroups at the beginning of the school year, and these differences do not disappear. Children from ethnic minorities and lower socioeconomic residence areas show relatively less developed political orientations, and they do not improve as much over the school year as other children. Furthermore, normative political orientations and cognitive orientations differ in their development.

Parents' Perceptions of Their Children in a Context of Shared Political Uncertainty: The Case of Jewish Settlers in the West Bank Before and After the Oslo Peace Agreement

Article

Feb 2002

Michal Shamai

This study describes the effect of a politically uncertain situation on the parents' experience and on the way they appraise their children's experience. The study focuses on Israeli families living in Judea and Samaria (the West Bank) during two periods: the Intifada (the indigenous Arab population's civil uprising) and the years following the Oslo peace agreements. The results of this study indicate the importance of the specific political situation and the particular context that is created for those who experience it. The supportive context of the Israeli population created by the right-wing government affected the parents' ability to withhold their feelings during the Intifada, while the lack of support of the left-wing government increased the expression of emergency feelings by parents. The children, according to the parents' appraisal, expressed more emergency feelings than their parents did during the Intifada. The number of feelings and their intensity diminished after the Oslo Agreements. The discussion focuses on the effect of family role and its interaction with the political uncertainty on the psychological well-being of parents and children.

Is Ideology a Risk Factor for PTSD Symptom Severity Among Israeli Political Evacuees?

Article

Aug 2010
J TRAUMA STRESS

To study the role of ideology in situations of extreme stress, a research questionnaire, measuring posttraumatic stress disorder (PTSD), settlement ideology (the importance of Jewish settlement in Gaza), and type of evacuation was administered to 326 Jewish residents who were evacuated from Gaza settlements by the Israeli government. Forty percent of the participants met the criteria of probable PTSD. Forcibly evicted individuals reported higher levels of settlement ideology and higher levels of PTSD symptom severity compared to voluntarily evacuated individuals. Contrary to previous studies, ideology was found to be positively associated with PTSD symptom severity. The results are explained by the conservation of resources and terror management theories. Theoretical and practical implications are discussed.

Preventive Interventions Among Children Exposed to Trauma of Armed Conflict: A Literature Review

Article

Mar 2010
AGGRESSIVE BEHAV

Increasing research is available on the preconditions for child mental health and optimal development in traumatic conditions, whereas less is known how to translate the findings into effective interventions to help traumatized children. This literature review analyses the effectiveness of psychosocial preventive interventions and treatments and their theoretical bases among children traumatized in the context of armed conflicts (war, military violence, terrorism and refugee). The first aim is to evaluate the effectiveness of preventive interventions in preventing emotional distress and impairment and promoting optimal emotional-cognitive and social development. The second task is to analyze the nature of the underlying mechanisms for the success of preventive interventions, and the theoretical premises of the choice of intervention techniques, procedures and tools. We found 16 relevant published studies, but an examination of them revealed that only four of them had experimental designs strong enough that they could be included in the meta-analysis. While the subjective reports of the researchers suggested that systematic preventive interventions were effective in decreasing PTSD and depressive symptoms among children traumatized due to armed conflict, the more objective results of the meta-analysis and the weaknesses in designs uncovered during the meta-analysis undermine such a conclusion. Additionally, a majority of the reported preventive interventions focused only on children's biased cognitive processes and negative emotions, while only a few aimed at influencing multiple domains of child development and improving developmental functioning on emotional, social and psychophysiological levels. It is concluded that substantial additional work needs to be done in developing effective preventive interventions and treatments for children traumatized by exposure to war and violence.

The Shifts in Hizbullah's Ideology: Religious Ideology, Political Ideology, and Political Program

Article

Jan 2006

Joseph Alagha

As the recent war in Lebanon demonstrated, an understanding of the Lebanese Shiâite militant group Hizbullah remains an important component of any attempt to solve the problems of the Middle East. The Shifts in Hizbullahâs Ideology provides an in-depth analysis of the groupâs motivations, tracking the changes it has undergone since Hizbullahâs founding by Lebanese Shiâite clergy in 1978. Joseph Alagha demonstrates that Hizbullah, driven at its founding chiefly by religious concerns, in the latter half of the 1980s became a full-fledged social movement, with a structure and ideology aimed at social change. Further changes in the 1990s led to Hizbullahâs becoming a mainstream political partyâbut without surrendering its militarism or willingness to use violence to advance its ends. In tracking these changes, The Shifts in Hizbullahâs Ideology covers such disparate topics as Hizbullahâs views of jihad, suicide and martyrdom, integration, pan-Islamism, anti-Zionism, and the relationship with Israel and the United States. It will be necessary reading for both scholars and policymakers.

Diagnosis of posttraumatic stress disorder

Article

Jun 1987

Rating Scales to Assess Depression in School-Aged Children

Article

Mar 1981

Maria Kovacs

To assess the severity of depression in school-aged children, self-report, clinician-rated and peer-rated instruments have been developed. Since these rating scales attempt to quantify an alleged clinical phenomenon, they represent a needed step toward more systematic scientific research into childhood depression. On the other hand, they are not diagnostic tools. The available instruments are promising but are still experimental. Additional data are needed to support their usefulness and accuracy as measurement devices.

Avoidant coping style and post-traumatic stress following motor vehicle accidents

Article

Aug 1995
BEHAV RES THER

Predictors of post-traumatic intrusive symptomatology were studied in 56 motor vehicle accident (MVA) survivors 12 months after their MVA. Measures were obtained on Ss' subjective response to the trauma, objective indices of injury severity, coping response (Coping Style Questionnaire), and post-traumatic stress (Impact of Event Scale; IES). Significant levels of intrusive and avoidance symptomatology were reported by 20% of MVA survivors. An avoidant coping style and compensation accounted for 41% of variance of IES-Intrusion scores. Findings are discussed in terms of the role of avoidance behaviour in post-traumatic adjustment.

Race, religious involvement and depressive symptomatology in a southeastern U.S. community

Article

Jul 1995

Christopher G. Ellison

A growing literature suggests that aspects of religious involvement may hold beneficial implications for mental health, and some also suggest that religion is an especially valuable mental health resource for racial minorities in the United States. These issues are explored empirically using data from a large (N = 2956) community sample drawn in the southeastern U.S. Findings include the following: (1) frequency of church attendance is inversely associated with depressive symptoms among whites, but not among blacks. (2) Absence of denominational affiliation is positively associated with depressive symptoms among blacks, but not among whites. (3) Frequency of private devotional activities (e.g. prayer) is positively associated with depressive symptoms among both racial groups. These results are discussed in terms of the distinctive history of the Black Church in the southern U.S. Several promising directions for further inquiry are outlined.

War Zone Stress, Personal Resources, and PTSD in Persian Gulf War Returnees

Article

Sep 1995

Can Ideological Commitment Protect Children's Psychosocial Well-Being in Situations of Political Violence?

Article

Mar 1996

Raija-Leena Punamäki

The mental health role of ideological commitment (operationalized as glorification of war, patriotic involvement, and defiant attitudes toward the enemy) was studied among 385 Israeli girls and boys (mean age 12 +/- 2.50). It was hypothesized that experiences of political hardships do not increase psychosocial problems if children have strong ideological commitment. The hypothesis was conditionally substantiated concerning symptoms of anxiety and insecurity, and depression and feelings of failure. Exposure to political hardships did not increase the presence of these symptoms among children who showed strong ideological commitment. In contrast, among children with weak ideological commitment, exposure increased these symptoms, but not linearily. Furthermore, injury and loss decreased social support if children show weak ideological commitment. There was also the mediating role of ideological commitment, showing that political hardships increased the ideological commitment that, in turn, was related to a low level of psychosocial problems.

Spirituality, Religion, and Depression in the Terminally Ill

Article

May 2002
PSYCHOSOMATICS

This study examined the impact of spirituality and religiosity on depressive symptom severity in a sample of terminally ill patients with cancer and AIDS. One hundred sixty-two patients were recruited from palliative-care facilities (hospitals and specialized nursing facilities), all of whom had a life expectancy <6 months. The primary variables used in this study were the FACIT Spiritual Well-Being Scale, a religiosity index similar to those used in previous research, the Hamilton Depression Rating Scale (HDRS), the Karnofsky Performance Rating Scale, the Memorial Symptom Assessment Scale, and the Duke-UNC Functional Social Support Questionnaire. A strong negative association was observed between the FACIT Spiritual Well-Being scale and the HDRS, but no such relationship was found for religiosity, because more religious individuals had somewhat higher scores on the HDRS. Similar patterns were observed for the FACIT subscales, finding a strong negative association between the meaning and peace subscale (which corresponds to the more existential aspects of spirituality) and HDRS scores, whereas a positive, albeit nonsignificant, association was observed for the faith subscale (which corresponds more closely to religiosity). These results suggest that the beneficial aspects of religion may be primarily those that relate to spiritual well-being rather than to religious practices per se. Implications for clinical interventions and palliative-care practice are discussed.

Adolescent understandings of political violence and psychological well-being: A qualitative study from Bosnia Herzegovina

Article

Nov 2002

Lynne Jones

The Harvard Trauma Questionnaire and Hopkins Symptoms Checklist (HSCL-25) were given to 337 13-15 year olds who had lived through the recent war in Bosnia Herzegovina, on opposite sides of the conflict. A gender-balanced sub-sample of 40 adolescents was selected on the basis of their combined symptom scores, including equal numbers of high and low scorers from each side. A year of participant observation in two cities and in-depth interviews were conducted with the sub-sample to explore their understandings of the war and their subjective perceptions of their psychological well-being. Case studies are presented to show that the degree to which an adolescent engaged in a search for meaning to the conflict is related to their psychological well-being. Searching for meaning did not appear to be protective. Less well adolescents in both cities were more engaged in searching for meaning. Well adolescents appeared to be more disengaged. Searching for meaning appeared to be associated with sensitivity to the political environment, and feelings of insecurity about the prospect of a future war. The particular local context had an important effect in mediating the manner in which disengagement and engagement occurred. These findings suggest that the more avoidant methods of coping with political violence warrant further investigation. Political engagement may be protective in low-level conflicts where there is a possibility for action. When there is little opportunity for active engagement, the search for meaning has a different effect. Adolescents engaged in the search for meaning recognise that their recovery is bound up with the recovery of their communities as a whole. Assistance and support may have to address the material, social and political difficulties that the search uncovers.

An Inventory For Measuring Depression

Article

Jul 1961
ARCH GEN PSYCHIAT

Mediation and Moderation of the Relationship Between Intrinsic Religiousness and Mental Health

Article

Apr 2005

The present study examined specific aspects of individuals' personal strivings as mediators, and religious tradition as a moderator, of the relationship between intrinsic religiousness and mental health. In a sample of 268 university students, the negative relationship between intrinsic religiousness and hostility was mediated by the degree of sanctification within individuals' strivings. The relationships between intrinsic religiousness and both anxiety and depression were moderated by religious tradition, with Catholics' intrinsic religiousness significantly associated with greater anxiety and depression but Protestants' intrinsic religiousness not significantly associated with either of these mental health variables. Implications of these results for future research on religiousness are discussed.

Risk and Protective Factors Mediating Psychological Symptoms and Ideological Commitment of Adolescents Facing Continuous Terrorism

Article

May 2006

This study evaluated symptoms, risk, and protective factors of adolescents from six Israeli schools exposed to continuous terrorism. All children in the grades selected at each school (7, 9, and 11) were administered anonymous assessment materials measuring posttraumatic, grief, and dissociative symptoms, as well as traumatic exposure, personal resilience, and family factors. A high number of risk factors increased the likelihood of negative symptoms. Perceived personal resilience served as a protective factor against symptom development, perhaps enforced by ideology. Girls living on the West Bank had less severe posttrauma and were more willing to make personal sacrifices for their country. Proactive interventions aimed at enhancing a child's personal resilience and ability to cope with continuous stress may help protect against later symptomatology following traumatic events. Facing terrorism, political ideology may serve a double edge sword: protecting against symptom development as well as contributing to the toxic cycle of violence.

Practitioner Review: Assessment and treatment of refugee children and adolescents who have experienced war-related trauma

Article

Jan 2007

Increasingly clinicians are being asked to assess and treat young refugees, who have experienced traumatic events due to war and organised violence. However, evidence-based guidance remains scarce. Published studies on the mental health difficulties of refugee children and adolescents, associated risk and protective factors, as well as effective interventions, particularly those designed to reduce war-related post-traumatic stress disorder (PTSD) symptoms, were identified and reviewed. The findings are summarised. Young refugees are frequently subjected to multiple traumatic events and severe losses, as well as ongoing stressors within the host country. Although young refugees are often resilient, many experience mental health difficulties, including PTSD, depression, anxiety and grief. An awareness of relevant risk and protective factors is important. A phased model of intervention is often useful and the need for a holistic approach crucial. Promising treatments for alleviating symptoms of war-related PTSD include cognitive behavioural treatment (CBT), testimonial psychotherapy, narrative exposure therapy (NET) and eye movement desensitisation and reprocessing (EMDR). Knowledge of the particular needs of unaccompanied asylum-seeking children (UASC), working with interpreters, cross-cultural differences, medico-legal report writing and the importance of clinician self-care is also necessary. More research is required in order to expand our limited knowledge base.

Impact of war, religiosity and ideology on PTSD and psychiatric disorders in adolescents from Gaza Strip and South Lebanon

Abstract

No full-text available

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Khamis, V. (2015). War, religiosity, ideology and PTSD in the Middle East. In V R Preedy (Ed.), Comp...